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Creating Demand: Direct to Consumer Drug Ads

September 25, 2013

In a recent interview for a European television station, I listened to the staff laugh at how “the fools” in America allow Big Pharma to advertise their billion dollar prescription drugs directly to the public, and with the same broadcast companies whose news agencies often report on them.

It brought me back to my experience on the NBC Today Show a few years back when I was interviewed about my new book, “What Your Doctor Won’t (or Can’t) Tell You.” But to begin this story allow me to discuss what direct-to-consumer advertising, better known in the industry as DTC, is all about.

Studies have clearly shown, as the industry is fully aware, that marketing drugs directly to the consumer, for example, AndroGel for middle-aged men, Restasis for patients with dry eyes, and Latisse for people who want longer lashes, increases their sales far more than drugs that are not marketed during a favorite TV show.

Watch the DTC ad for Latisse and you’ll clearly see and remember beautiful women with magnificent lashes, but I suspect you won’t recall the FDA-mandated warnings the spokeswoman mentions in a melodic, seemingly optimistic voice.

Were you aware that the drug could cause permanent discoloration of your eyes, browning of your lids, or even hair growth in areas below the lid? And do you know you’ll have to take the drug forever if you wish the effects to be permanent?

As we know, industry has no problem finding some doctor or celebrity willing to prostitute themselves and I must say they certainly do a great job.

The FDA is aware of the risks of DTC ads and in 2004 published a survey of physicians about this. Some of the findings included:

  • Physicians thought the ads did not convey information about risks and benefits equally well. 65 percent believe DTC ads confuse patients about the relative risks and benefits of prescription drugs. In addition, about 75 percent of physicians surveyed believed that DTC ads cause patients to think that the drug works better than it does, and many physicians felt some pressure to prescribe something when patients mentioned DTC ads.
  • Eight percent of physicians said they felt very pressured to prescribe the specific brand-name drug when asked.

In 2004 I found myself indirectly affected by DTC ads — collateral damage, if you will, caused by the profitability of DTC advertising. It was my first and what would end up being my most important interview to promote my book, “What Your Doctor Won’t (or Can’t) Tell You.” I was invited to talk live on the Today Show with Ann Curry. I was quite anxious about going before the cameras but determined to tell my story.

I was interviewed by the producer of the segment two days prior to the live interview. She warned me in no uncertain terms not to discuss anything about the pharmaceutical industry. Naively, I tried to convince her that my chapter on Big Pharma was the best and most enlightening — and probably most damning — portion of my book. But she was quite emphatic: no one would be interested in it and I was not to discuss it. Alas, my iconoclastic instincts prevailed and I became more concerned with the producer’s attempted censorship than with promoting my book. When I sat down with Ann Curry a few minutes before the interview, I told her about the producer’s warning and asked her if that was because so many of the Today Show’s commercials were paid for by Big Pharma.

Ms. Curry, I remember, seemed quite offended by my question and told me I could discuss anything I thought was relevant to my book. I don’t believe she realized what her producer intended, but I did. And so when she asked her first question, carefully scripted by her producers, I managed to talk about the pharmaceutical companies and the expensive, though not always superior, medications they coax some doctors into prescribing.

I did not hear her scream, but I suspect the producer was apoplectic. Ann was very professional and courteous during the remainder of the interview, but I left wondering if I had just screwed myself and my publisher by not playing the game. As it turned out, the “live” interview had been taped and not shown because of breaking news coverage.

Several days later while I was out on my book tour, both my agent and my publisher called to let me know that the folks at NBC thought that I performed so poorly on my interview that they could not televise it. A week later, however, my agent called me to tell me he had reviewed the DVD of the interview and thought I had done very well. It was then that I realized what had likely happened. I had broached a subject that was verboten; violated a taboo: don’t talk about Big Pharma. The punishment for that was to have my interview put on a shelf instead of on the air.

Getting to Ann Curry, the only person who could help me, was not an easy task as my agent and publisher had pretty much called it a day the week after my publication date. But like any street-smart Brooklyn boy would, I figured I could send her a message in the form of a floral arrangement. And so with a quick call I ordered a huge assortment of flowers and left a message that said, “Ann, I thought you said I could talk about anything I wanted to. Thanks, Dr. Evan Levine.”

A day later the interview aired on the Today Show, although the staff never gave a courtesy heads-up to anyone at Putnam Publishing, to my agent, or even to me. The interview is now on Youtube : Today Show interview with Dr. Evan Lavine

Readers, you be the judges. Let me know if you think I did so poorly that the piece should not have been aired or whether you suspect that network sensitivity to cash-cow advertisers like Big Pharma may have played a role in the initial shelving of the segment.


About the Author: Dr. Evan S. Levine is a cardiologist in New York and a Clinical Assistant Professor of Medicine at Montefiore Medical Center – Albert Einstein College of Medicine. He is also the author of the book “What Your Doctor Won’t (or can’t) Tell You”. He lives in Connecticut with his wife and children.



4 Responses to Creating Demand: Direct to Consumer Drug Ads

  1. SteveH on October 19, 2013 at 6:24 pm

    It’s about power. Pharmaceutical companies, because of the profit that part of the economy generates, have become lobbying powers. To hell with the safety of the American people. Profits matter, people don’t.

  2. heartdude on October 19, 2013 at 6:04 pm

    Who knows where this crap is being smeared and what little girl may be affected? Perhaps a child whose dad or teacher uses it daily will be exposed to enough T to cause some type of illness or create risk of being sterile later in life.

  3. E.Brock on October 18, 2013 at 10:47 pm

    What kind of safeguards do the pharmaceuticals who make these testosterone supplements, and the doctors who prescribe them, put in place? A warning not to get it on your children or wife. That’s it? So what about people that don’t give a shit? What about people working in the kitchens of restaurants and fast food, what about the guy who puts some on in the bus and then smears some on the rail? How about something sensible like putting a bright and phosphorescent die in the stuff so it can easy be seen. We’re all at risk now and there’s no way to protect ourselves.

  4. liberalvoice on October 2, 2013 at 3:52 pm

    Direct to consumer ads for drugs that only doctors are legally allowed to prescribe seems at odds with the logic underlying controlled substances policy. At least the FDA can mandate that harmful side-effects be enumerated during the commercials. As lacking in wisdom as allowing the marketing of drugs directly to consumers seems, it’s only one of the many serious defects of the overall healthcare system in the U.S. At least the Patient Protection and Affordable Care Act is addressing many of those defects. Let us pray that the Republicans fail in their obsessive and mean-spirited attempt to undo it and deny something like 48 million Americans the right to have healthcare insurance even if they have a preexisting condition.

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